Peritoneal dialysis catheter with an expandable structure

Abstract

Disclosed are peritoneal dialysis catheters comprising a distal region comprising a perforated portion and one or more expandable member configured to float the catheters on dialysate fluid within the peritoneal cavity of a patient, and methods for using the catheters.

What is claimed: 
     
         1 . A device comprising:
 an elongated tubular member comprising a proximal region, a distal region, and a wall defining a first lumen and a second lumen extending from the proximal region to the distal region, wherein a portion of the wall disposed at the distal region includes perforations in fluid communication with the first lumen, and   a float disposed on the tubular member in fluid communication with the second lumen configured to float the distal region near an upper level of peritoneal fluid within a subject's peritoneal cavity;   wherein the first lumen is a fluid lumen and the second lumen is an inflation lumen.   
     
     
         2 . The device of  claim 1  wherein the float comprises an expandable member comprising an elastomeric sheath configured in a compressed configuration for insertion into the subject's peritoneal cavity and expanded after the insertion. 
     
     
         3 . The device of  claim 2  wherein the expandable member is disposed longitudinally along a portion of the distal region. 
     
     
         4 . The device of  claim 2  wherein the expandable member is sized to encapsulate at least a portion of a circumference of at least a portion of the elongated tubular member. 
     
     
         5 . The device of  claim 2  wherein the expandable member comprises a silicone sheath that defines a cavity and an open cell foam insert in the cavity. 
     
     
         6 . The device of  claim 2  wherein the expandable member comprises a silicone sheath that defines a cavity and a closed cell foam insert in the cavity. 
     
     
         7 . The device of  claim 2  wherein the expandable member fully encapsulates at least a portion of the elongated tubular member. 
     
     
         8 . The device of  claim 2  wherein the wall portion comprising the plurality of perforations is disposed along the elongated tubular member distal to the expandable member. 
     
     
         9 . The device of  claim 8  wherein the wall comprising the plurality of perforations has a curved configuration. 
     
     
         10 . The device of  claim 9  wherein the curved configuration has a spiral shape. 
     
     
         11 . The device of  claim 9  wherein the distal region comprises a shape memory to allow the distal end to assume an expanded, curved configuration after the insertion into the subject's peritoneal cavity. 
     
     
         12 . The device of  claim 2 , wherein the expandable member comprises a material selected from the group consisting of a nylon, polyamide, polyolefin, polyester, polyurethane, fluoropolymer, polyethylene, polytetrafluoroethylene (PTFE), polyethyleneterephthalate (PET), polyvinyl chloride, latex, natural rubber, synthetic rubber, silicone and mixtures and copolymers thereof. 
     
     
         13 . The device of  claim 1 , wherein the elongated tubular member further comprises at least one cuff positioned on the wall of the elongated tubular member in the proximal region. 
     
     
         14 . The device of  claim 13 , wherein the at least one cuff includes first and second cuffs. 
     
     
         15 . The device of  claim 1  wherein the wall of the elongated tubular member further comprises a radiopaque stripe extending from the proximal region to the distal region. 
     
     
         16 . The device of  claim 2  wherein the elongated tubular member further comprises a retractable non-expandable sheath disposed radially outside the expandable member during insertion of the device into within a subject's peritoneal cavity. 
     
     
         17 . The device of  claim 1  wherein the elongated tubular member further comprises a fitting mechanism operatively engaged to the proximal region of the elongated tubular member, wherein the fitting mechanism comprises a first passage in fluid communication with the first lumen and is capable of controlling fluid flow through the first lumen, and a second passage in fluid communication with the second lumen. 
     
     
         18 . A kit comprising the device of  claim 1  and a fitting mechanism configured to engage the device, wherein the fitting mechanism comprises a first passage in fluid communication with the first lumen and is capable of controlling fluid flow through the first lumen, and a second passage in fluid communication with the second lumen when engaged to the device. 
     
     
         19 . The kit of  claim 18  further comprising a stylet to guide insertion of the device into the subject's peritoneal cavity. 
     
     
         20 . The kit of  claim 18  further comprising a cutting tool to create an opening into the subject's peritoneal cavity to insert the device.